What to do when you need healthcare

Congratulations! You have arrived in one of the world’s happiest and healthiest countries. The Netherlands consistently ranks in any top ten list for health care quality. If as an expat you need medical care, you can rest assured that you won’t have to worry about the costs, due to the wide-ranging health insurance system. The mandatory basic insurance package (basisverzekering) covers a large number of medical services. With additional coverage you can choose to opt in for more services as you see fit. If you are on a low income, the government will fully or partially reimburse your insurance premium.

Currently, there are three dimensions to the Dutch healthcare system:

  • Basic healthcare, which includes GP visits, hospital stays and a wide range of specialist procedures.
  • Supplementary care, including physiotherapy, dental care and cosmetic operations.
  • Long-term care for chronic conditions, including disability expenditures, which may fall fully or partially under the first and second categories of mandatory and additional insurance.

Before you select an insurer and health coverage package, the first thing to do is to find a general practitioner (GP, or huisarts) close to where you live. You can find them online at Ik zoek een huisarts (in Dutch), at your local municipality, or ask your neighbour or a local Facebook group for recommendations. Note that some GP practices are full, so you may have to ask a few before you are accepted.

Your GP is the first point of contact whenever you have a health issue. Some doctors offer walk-in visits, but many only see patients by appointment. Some doctors also do home visits, especially for frail and elderly patients. As the gatekeeper of the medical system, only a GP can refer you to a specialist or the hospital (for non-emergency situations). Your GP will probably request to discuss and note down your medical history, so that any future healthcare professionals have the advantage of access to your latest health records.

Unlike most other countries, in the Netherlands it’s not advisable go directly to the emergency department (spoedeisende hulp). You can do so, but you will either be referred back to the GP or you will have to wait a long time to be seen; moreover, you will most likely have to pay out of your own eigen risico (see page ..). If there is a life-threatening situation, call 112 for an ambulance. Otherwise, you will have to call your GP, who will refer you to the emergency department if he/she thinks the situation is serious. If your GP is unavailable, you call the on-duty GP centre (huisartsenpost), which is usually right next to the hospital. You GP’s answering message will give you the number of the on-duty GP centre, or look it up online.

There are three kinds of hospitals in the Netherlands:

  • General hospitals deliver good care, but are not specialized and will refer you to another hospital if you have a complicated illness.
  • Teaching hospitals work with medical schools for training healthcare practitioners.
  • Academic hospitals are directly connected to the major universities. Many doctors here are also researchers and these hospitals deliver the greatest variety of specialized care.

When staying in a Dutch hospital, you are likely to share a room or ward with up to five other patients, often mixed-gender. There are special wards for children. The Netherlands also has a number of specialized children’s hospitals, with more facilities to keep the little ones entertained or even help them with their school work. Many children’s hospitals allow parents to stay overnight in on-site accommodation.

Specialist care
If you are in need of specialist, non-emergency care, you will probably be referred to a hospital. In this case, you will need a referral from your GP, which you will have to send to your insurer in order for your expenses to be covered. As soon as you have your referral, you can make an appointment with the specialist your GP recommends, or look around (online) to find out which specialist you prefer. You can make an appointment with the specialist’s office directly. At kiesbeter.nl (in Dutch) you can compare hospitals and their specializations, as well as private doctors, in order to find one that’s best suited to your needs.

When visiting a hospital for the first time, you need to register at the front desk with your contact details, the name of your GP and your insurance information. This information will then be recorded and stored in the hospital system. You will receive an electronic patient card (patiëntenpas) which you will have to bring with you on each visit. With this ‘medical passport’, your history can be accessed by the doctor treating you, and your bills will be sent automatically to your insurance company. If you are referred to a hospital, you will also need to show your GP’s referral and any notes s/he made. They will be passed on to the specialist before you go in. During the first appointment, which typically doesn’t take longer than ten minutes, a first diagnosis will be made in order to decide further treatment.

Going to the dentist
All dentistry is private in the Netherlands, and basic insurance policies do not cover going to the dentist for a check-up or simple treatment. However, all dental care for children under 18, as well as all specialist dental care, is covered. You need to take out additional insurance if you want your standard dental costs to be covered, up to maximum of 75% of the total cost. Pretty much all insurance companies offer an extensive dental plan under the additional coverage (aanvullende verzekering). Most dentists and orthodontists operate from their own practice, often located in their homes, although more and more practices now work together with several dental specialists. The most specialized forms of dental care, such as surgery, will take place at hospitals. To visit specialized dental care, you need a referral from your regular dentist.

If you’ve had an accident and need to recover, or if you suffer from chronic or acute physical problems, you may need physiotherapy. The basic health insurance package only partially covers physiotherapy, depending on your age and therapy needs. You can take out additional insurance for care that is not included in the basic insurance package. Those younger than 18 get their first nine sessions reimbursed, possibly followed by another nine. Those over 18 with a chronic condition will have to pay for their first 20 sessions, after which all physiotherapy is fully paid for.

Mental healthcare
If you have mental health problems, you can contact your GP or, if the problem is work-related, your company doctor (bedrijfsarts), or look for help online. If the problem becomes too serious for you to handle on your own, your doctor might refer you to specialist care. Going to a psychologist, therapist or counsellor for primary care (mild to moderate problems) and secondary care (serious and complex psychiatric disorders) are both covered by your insurer, but do check your insurance policy to determine whether you should take out additional coverage. Private counseling is usually not covered by insurance.